This study will determine which level of blood pressure best reverses left ventricular hypertropny, renal failure and improves natriuresis in hypertensive patients. The cystic involvement of the kidney in ADPKD is associated with a high incidence of hypertension, left ventricular hypertrophy (LVH) and progression of chronic renal failure. Aggressive control of blood pressure will regress LVH and reverse the progression of chronic renal failure. Specifically the aim is to determine if control of blood pressure to a mean arterial pressure (MAP) of <=92 mm Hg will be more effective in slowing LVH and reversing the progression of chronic renal failure in ADPKD than will blood pressures maintained at the accepted upper limits of normal (MAP of 100 - 107 mm Hg). This protocol will provide important information regarding the long-term effects of antihypertensive therapy and level of blood pressure control in hypertensive ADPKD patients with regard to retardation of loss of renal function and regression of LVH. The number of patients and the long-term nature of this study will provide important guidelines to clinicians managing hypertensive ADPKD patients as well as provide information regarding risk factors for poor renal outcome in these patients.